PO-107: Role of Honey in Prevention of Radiation Induced Mucositis in Head and Neck Cancer

Alvi, Zeeshan Ahmed; Mahmood, Ameera Aziz; Rasool, Shabhat; Ali, Usman; Arif, Salman; Ishtiaq, Sundas; Maqsood, Talha

doi:10.1016/s0167-8140(15)34726-5

Cited by 10 publications

(23 citation statements)

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“… 41 - 61 Moreover, 25 clinical trials were identified examining honey alone or in combination as a prophylaxis/intervention for oral mucositis ( Table 3 ). 62 - 87…”

Section: Resultsmentioning

confidence: 99%

Adjunctive Treatments for the Prevention of Chemotherapy- and Radiotherapy-Induced Mucositis

2018

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Background: Chemoradiotherapy-associated mucositis can manifest as pain, inflammation, dysphagia, diarrhea, weight loss, rectal bleeding, and infection. Mucositis is a major dose-limiting side effect of chemotherapy, affecting nutritional intake and oral and intestinal function. Despite several interventions being available, there is a need for safe and effective preventative and treatment options for treatment-induced mucositis. The goals of this review are to discuss interventions based on foods and natural products and present the research to date. Methods: A narrative literature review identified 60 clinical studies examining various nutritional compounds and 20 examining probiotics. 9 studies on probiotics for the prevention of diarrhea were also assessed on methodological quality and limitations identified. Results: Several compounds have been posited as useful adjuvants for cancer treatment–related mucositis. Probiotics demonstrate efficacy for the prevention and treatment of chemoradiotherapy-induced gastrointestinal toxicity without significant side effects. Glutamine and activated charcoal were reported to reduce chemotherapy-induced diarrhea but not radiation-induced intestinal mucositis. Honey has been reported to decrease treatment interruptions, weight loss, and delays the onset of oral mucositis. Zinc, glutamine, and topical vitamin E were demonstrated efficacy for oral mucositis. Conclusion: There is plausible clinical evidence for the administration of several adjunctive treatments for the prevention and treatment of mucositis. Probiotics were reported to reduce the burden of intestinal mucositis and treatment-induced diarrhea. Activated charcoal and glutamine are beneficial for chemotherapy-induced diarrhea, whereas the administration of honey, zinc, and glutamine reduce the risk of developing oral mucositis during chemotherapy or radiotherapy.

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“… 41 - 61 Moreover, 25 clinical trials were identified examining honey alone or in combination as a prophylaxis/intervention for oral mucositis ( Table 3 ). 62 - 87…”

Section: Resultsmentioning

confidence: 99%

Adjunctive Treatments for the Prevention of Chemotherapy- and Radiotherapy-Induced Mucositis

2018

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“…Method of administration of honey or control was essentially similar, which consisted of swish, hold, and gradually swallow to coat the oral and pharyngeal area, whereas in 1 study, the patients were asked to expectorate the control substance . This was given as 20 mL 3 times per day in 4 studies and 5 mL in 1 study . Four studies allowed concurrent chemoradiation, 2 studies with radiotherapy alone, and 2 studies did not mention usage of chemotherapy .…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of honey on radiation-induced oral mucositis, time to mucositis, weight loss, and treatment interruptions among patients with head and neck malignancies: A meta-analysis and systematic review of literature

Mejia

Que

et al. 2016

Head Neck

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There is current evidence that honey is beneficial for patients with head and neck cancers by decreasing treatment interruptions, weight loss, and delaying the onset of oral mucositis, but not in decreasing peak mucositis score. In light of the results, honey is a reasonable treatment for radiation-induced mucositis, but more randomized clinical trials (RCTs) should be done. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1119-1128, 2016.

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“…We designed Table 1 to document details of characteristics of all eligible trials. All studies (5,(40)(41)(42)(43)(44)(45) were published between 2003 and 2017. The sample size of a single trial was ranging from 40 to 82, with a median sample size of 60.…”

Section: Details Of Characteristics Of All Eligible Trialsmentioning

confidence: 99%

“…However, control regimes in eligible trials were different. Of 7 trials, 4 used normal saline (40,41,44,45), 1 used lignocaine gel (43), 1 used water mouthwash (42), and 1 used standard protocol (5). Three trials used the Radiation Therapy Oncology Group (RTOG) grading system to evaluate the severity of oral mucositis (5,40,43), 3 used the World Health Organization (WHO) grading system to assess the grade of oral mucositis (41,42,45), and 1 used the Oral Mucositis Assessing Scale (OMAS) to grade the severity of oral mucositis (44).…”

Section: Details Of Characteristics Of All Eligible Trialsmentioning

confidence: 99%

“…Of 7 trials, 4 used normal saline (40,41,44,45), 1 used lignocaine gel (43), 1 used water mouthwash (42), and 1 used standard protocol (5). Three trials used the Radiation Therapy Oncology Group (RTOG) grading system to evaluate the severity of oral mucositis (5,40,43), 3 used the World Health Organization (WHO) grading system to assess the grade of oral mucositis (41,42,45), and 1 used the Oral Mucositis Assessing Scale (OMAS) to grade the severity of oral mucositis (44). Two trials reported an incidence of radiation-induced oral mucositis (5,41), 6 reported incidence of severe radiation-induced oral mucositis (5,(41)(42)(43)(44)(45), and 2 reported weight maintenance and treatment interruption related to oral mucositis (5,41).…”

Section: Details Of Characteristics Of All Eligible Trialsmentioning

confidence: 99%

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Impact of honey on radiotherapy-induced oral mucositis

Xu¹

2020

Ann Palliat Med

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Background: Oral mucositis is one of the most frequent, irreversible and distressing complications faced by head and neck cancer (HNC) patients undergoing radiotherapy. Several studies have investigated the role of honey in the prevention and alleviation of radiation-induced oral mucositis in HNC patients, however, a definitive conclusion has not yet been generated. We performed this updated systematic review and metaanalysis to determine whether honey can prevent and alleviate radiation-induced oral mucositis in HNC patients. Methods: We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and China National Knowledge Infrastructure (CNKI) through October 2019. We searched and selected literature, extracted data and assessed risk of bias accordingly, and then conducted statistical analyses with RevMan software version 5.3. Results: Seven trials involving 412 patients were included in the final analysis. Meta-analyses showed that honey did not decrease the incidence of radiation-induced oral mucositis [(relative risk (RR), 0.69; 95% confidence interval (CI), 0.40-1.18; P=0.18]; however, relieved the severity of oral mucositis (RR, 0.22; 95% CI, 0.13-0.38; P<0.001), maintained or increased weight (RR, 1.92; 95% CI, 1.33-2.77; P<0.001) and reduced the treatment interruption related to oral mucositis (RR, 0.13; 95% CI, 0.02-0.97; P=0.05). Qualitative analysis also revealed a decreased incidence of oral mucositis in the honey group. Conclusions: Based on limited evidence, honey may have a clinical benefit against radiation-induced oral mucositis in HNC patients. However, future trials with large-scale and rigorous methods are warranted to further establish the role of honey in the management of radiation-induced oral mucositis.

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PO-107: Role of Honey in Prevention of Radiation Induced Mucositis in Head and Neck Cancer

Cited by 10 publications

References 0 publications

Adjunctive Treatments for the Prevention of Chemotherapy- and Radiotherapy-Induced Mucositis

Adjunctive Treatments for the Prevention of Chemotherapy- and Radiotherapy-Induced Mucositis

Effectiveness of honey on radiation-induced oral mucositis, time to mucositis, weight loss, and treatment interruptions among patients with head and neck malignancies: A meta-analysis and systematic review of literature

Impact of honey on radiotherapy-induced oral mucositis

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